A must-read. Gary Schwitzer notes some of the more recent citations by major media where they blatantly ignored the evidence of cancer screening tests (NBC’s Nancy Snyderman is the worst offender in my opinion).
I am all for evidence-based cancer screening, and a balanced view needs to be communicated. This includes the very real risks of screening, including the concept of false positives and the harms of the test itself.
So, why doesn’t the media do this? Because they are too damn lazy. Explaining the evidence takes work, and many media members don’t bother with the effort:
“The pro-screening bias comes down to being able to promote a piece,” says Maria Simbra, M.D. She’s a medical reporter for KDKA-TV in Pittsburgh and a member of the Association of Health Care Journalists’ (AHCJ) board of directors.”TV news loves to be able to tell viewers to do something. It’s more promotable than saying, ‘Well, maybe you should just hold off until we understand more.’ Furthermore, emotion plays well on TV — perhaps better than medical evidence.”And evidence, Simbra says, takes a long time to explain. So television news may have an inherent bias in favor of screening. “How do you show the human side of not getting screened?” she asks.
Simbra’s fellow AHJC board member Phil Galewitz is a medical reporter for The Palm Beach (Fla.) Post. He says, “It’s difficult for reporters to focus stories about people getting screened unnecessarily when many aren’t getting screened at all.
“I would guess few health reporters are even aware of the U. S. Preventive Services Task Force guidelines and the same probably goes for the American College of Physicians. That’s a shame because they often have the most updated and reliable standards.”
Another AHCJ board member, freelance health journalist Andrew Holtz in Portland, Ore., says the quick and easy approach is not to question screening.
“When experts confirm what journalists want to hear, that is, that a screening test saves lives, (journalists) often stop looking for more information or other sources. And because too many reporters and editors lack training in critical thinking on medical or science topics, they fail to challenge expert sources.
Related posts:
- Media bias against the evidence
- The media’s bias against the harms of cancer screening
- CNN dismisses the ACP on breast cancer screening
- The "John Q" murder and media bias
- Dr. John Corso: Another physician ignoring the evidence
- How the media is being bought by the pharmaceutical industry
- Chicago Sun-Times gets prostate cancer screening wrong
{ 2 comments }
What if, after explaining everything to a patient about screening tests – the concepts of false-positives/negatives, possibilities of further testing and potential complications, etc, and the patient STILL wants the test? Is it acceptable to order it? It seems to me that we are arguing that the patient accept our arguments about unquantifiable risks (potential for anguish, potential for further testing and potential complications, potential false security, etc) for the potential risk of missing something that the patient might really have. In other words, the value to the patient of having an answer, even if it’s a qualified one, is worth more to them than the potential enumerated risks. Why can’t they decide this for themselves?
Great site, by the way. Thanks for putting it together!
I am not sure these risks are “unquantifiable”. The rate of false positives for many tests is known, the additional tests performed after false positives are known, the risk of these tests is known as well. So the risks are very quantifiable. Similarly, the radiation risk of CT scans is known as well. A lot more of your patients would be willing to ignore vague unquantifiable risk of anguish then “about 50% chance of at least one false positive after 10 yearly screens” for example.
Also, I don’t understand why neither Kevin nor dl mentions overdiagnosis as one of the risks of some of the tests. I’d imagine to many people the possibility of suffering serious life-threatening side-effects would look more serious that a potential for anguish. Of course, this can be expressed not in vague “potential” terms but in clear “your risk of being diagnosed with this desease is higher if you get screened”.
I do agree with dl that people should be able to decide for themselves. But they should decide based on accurate information. I find the fact that neither Kevin nor dl even mentioned overdiagnosis as a possible risk a bit strange.
As far as the media is concerned – journalists are patients themselves and they’ve been subjected to the same endless promotion of screening for years. If you want to blame somebody for media bias blame “TV doctors”, not journalists.
Comments on this entry are closed.